“I’ve got the whole world in my hands,” goes the popular children’s song. Never has it been more true than today. With the power of hand-held mobile technology comes the opportunity to impact public health around the world. It’s already happening in regions in Africa where mobile health technology initiatives (often referred to as mHealth) are vastly improving healthcare access and delivery—all from the palm of your hand.
Until recently, the promise of mHealth initiatives has far outpaced reality. A lack of reliable internet and phone networks in developing African countries impeded mHealth initiatives in global health. But these infrastructures have improved, and healthcare workers have been able to leverage technology to reach wider populations. Mobile network subscriptions on the African continent grew from 4 million users in 1998 to more than 800 million users in 2014. Africa remains the second-most mobile connected continent by population, with the majority of its population under the age of 30. For many of these mobile subscribers, the newfound access to information translates to an access to healthcare they might otherwise not have.
As with most new enterprises, healthcare workers in African regions started with the “low hanging fruit.” As many diseases are more easily spread due to a lack of information, or misinformation, early mHealth initiatives began with education campaigns. One such campaign in Kenya allowed mobile subscribers to check the legitimacy of healthcare workers by using a locally developed app. Through texting, users receive a list of approved clinicians and hospitals nearby. The campaign served a pressing need because “phony” doctors had become so commonplace that they presented a significant public health danger. When the campaign launched in 2013, it received near 20 texts each day. This year the platform has received roughly 215 daily texts, meaning tens of thousands of Kenyans have leveraged mobile technology to receive credible healthcare information.
The benefits of mHealth initiatives are clear: cost-effectiveness, scalability and portability. All of which align to address the unique challenges healthcare workers across Africa face. Fifteen percent of the world’s population lives in Africa. Yet, the continent disproportionately carries 24 percent of the world’s disease burden and only 3 percent of the global healthcare workforce. MHealth initiatives offer viable solutions for overburdened healthcare workers tasked with doing more with less.
Those same workers are now unleashing the potential of mobile technology to tackle the most serious healthcare issues. Malaria No More (MNM) is a non-profit that plans to eradicate malaria by the year 2040. According to MNM, malaria accounts for half of the preventable absenteeism in African schools, causing 10 million missed school days each year. But more significantly, malaria carries a devastating human toll in Africa, claiming the life of one child every minute. MNM is now combining traditional strategies of early diagnosis, preventive practices and vaccine management with mHealth initiatives to drive life-saving results. For example, malaria diagnostic tests result in a “0” or “1.” This result is easily transmittable through mobile platforms, which allows healthcare workers to more quickly identify malaria outbreaks and coordinate a response. SMS reminders are also effective in driving appropriate use of mosquito nets and steering individuals toward treatment when symptoms appear.
The benefits of mHealth initiatives are clear: cost-effectiveness, scalability and portability.
The increase in mobile accessibility across Africa has sparked many ambitious mHealth initiatives tackling a wide array of disease states:
- In Mozambique, a text message initiative improved the rate of early infant diagnosis among HIV-positive new mothers.
- In South Africa, the MAMA SMS initiative sends participating mothers up to 60 texts with health information from credible sources.
- Ebola-stricken nations used text campaigns to track the spread of the disease and warn residents of its risk factors and symptoms.
- Uganda’s "Tobacco Kills, Say No and Save Lives" campaign uses social media and text messaging to alert people about the dangers of tobacco use
To reach its full potential, mHealth initiatives will need to overcome challenges around population literacy and network reliability. But healthcare workers can build on the success of early initiatives with more sophisticated campaigns tackling more complex issues like medication adherence, counterfeit drug detection and drug supply chain management.